Clinical Characteristics of Patients with Tetralogy of Fallot who Underwent an Invasive Procedure for Arrhythmias

Authors

  • Barbara Adelmann de Lima Pontifícia Universidade Católica do Rio Grande do Sul - Escola de Medicina – Porto Alegre (RS), Brazil. https://orcid.org/0000-0002-3531-4128
  • Antonio Carlos Gallo da Silva Universidade Federal de Ciências da Saúde de Porto Alegre – Porto Alegre (RS), Brazil.
  • Marco Aurélio Lumertz Saffi Universidade Federal de Ciências da Saúde de Porto Alegre – Porto Alegre (RS), Brazil.
  • Clóvis Fröemming Junior Instituto de Cardiologia do Rio Grande do Sul – Porto Alegre (RS), Brazil.
  • Gabriela Castilhos Instituto de Cardiologia do Rio Grande do Sul – Porto Alegre (RS), Brazil. https://orcid.org/0000-0001-6738-6065
  • Marcelo Lapa Kruse Instituto de Cardiologia do Rio Grande do Sul – Porto Alegre (RS), Brazil.
  • Gustavo Glotz de Lima Universidade Federal de Ciências da Saúde de Porto Alegre – Porto Alegre (RS), Brazil. / Instituto de Cardiologia do Rio Grande do Sul – Porto Alegre (RS), Brazil.
  • Tiago Luiz Luz Leiria Instituto de Cardiologia do Rio Grande do Sul – Porto Alegre (RS), Brazil.

Keywords:

Tetralogy of Fallot, Cardiac Electrophysiology, Tetralogy of Fallot, Arrhythmias, Cardiac

Abstract

Introduction: Tetralogy of Fallot (TOF) is a cyanotic congenital heart disease that has an incidence of sudden cardiac death of 0.2% per year, being arrhythmias the main cause of its occurrence. Objective: To compare characteristics of TOF patients referred for electrophysiological study (EPS) against those that were not (No-EPS). Method: Retrospective cohort with 215 patients (57.2% men; age = 29 ± 4) with corrected TOF (median of three years, ranging from 0.33 to 51) that underwent EPS between 2009-2020. The primary outcome was composed of death, implantable cardiac defibrillator (ICD) requirement and hospitalization. Results: Pre-syncope (EPS = 4.7%, No-EPS = 0%; p = 0.004), syncope (EPS = 7.1%, No-EPS = 1.7%; p = 0.056) and palpitations (EPS = 31%, No-EPS = 5.8%; p < 0.001) were symptoms that justified electrophysiological investigation. ICD was implanted in 24% of EPS and 0.6% of No-EPS (p=0.001). Twenty-six percent of the EPS group presented non-sustained ventricular tachycardia, while 0% in No-EPS (p = 0.012). The EPS group had more atrial fibrillation or atrial Flutter (35.7% vs. 6.9%; p < 0.001). The EPS patients had a wider QRS duration than the no-EPS group (171.12 ± 29.52 ms vs. 147 ± 29.77 ms; p < 0.001). Also, 26.2% of EPS performed ablation to correct macroreentrant atrial tachycardias. The incidence of primary outcome (death + ICD requirement + hospitalization) was higher in patients in the EPS group compared to the No-EPS group (p = 0.001). However, the total of seven deaths occurred during the clinical follow-up, but without differences between the groups (EPS = 4.7% vs. No-EPS = 2.8%; p = 0.480). Conclusion: EPS group had a profile of greater risk, more complex heart disease, and a greater occurrence of the primary outcome when compared to the No-EPS group.

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References

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Published

17-12-2021

How to Cite

Adelmann de Lima, B., Gallo da Silva, A. C., Saffi, M. A. L., Fröemming Junior, C., Castilhos, G. ., Lapa Kruse , M., Glotz de Lima, G. ., & Luz Leiria, T. L. (2021). Clinical Characteristics of Patients with Tetralogy of Fallot who Underwent an Invasive Procedure for Arrhythmias. JOURNAL OF CARDIAC ARRHYTHMIAS, 34(3), 91–99. Retrieved from https://jca.org.br/jca/article/view/3452

Issue

Section

Clinical Arrythmia